Coronary collateral growth by external counterpulsation: a randomised controlled trial

Gloekler, Steffen; Meier, Pascal; Marchi, Stefano F. de; Rutz, Tobias; Traupe, Tobias; Rimoldi, Stefano F.; Wustmann, Kerstin; Steck, Hélène; Cook, Stéphane; Vogel, Rolf; Togni, Mario; Seiler, Christian

doi:10.1136/hrt.2009.184507

Cited by 74 publications

(61 citation statements)

References 18 publications

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“…Interestingly, two noninvasive therapeutic approaches to increase FSS in the coronary vascular network are being tested to promote collateral flow: physical reeducation (under trial, ref. 98) and external counterpulsation with pneumatic cuffs (99,100).…”

Section: Collateral Growth and Flow-dependent Remodelingmentioning

confidence: 99%

Endothelial fluid shear stress sensing in vascular health and disease

Baeyens

Bandyopadhyay

Coon

et al. 2016

Journal of Clinical Investigation

447

407

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Section: Collateral Growth and Flow-dependent Remodelingmentioning

confidence: 99%

Endothelial fluid shear stress sensing in vascular health and disease

Baeyens

Bandyopadhyay

Coon

et al. 2016

Journal of Clinical Investigation

447

407

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“…5 ECP has been demonstrated to improve the perfusion of vital organs through diastolic augmentation. 6 Myocardial perfusion and coronary collateral flow in patients with coronary artery disease significantly increased after ECP, [7][8][9] which may contribute to clinical benefits of ECP. Hypertension is a well-known risk factor for first or recurrent stroke, [10][11][12] but the blood pressure management in acute stroke is controversial in recent years.…”

mentioning

confidence: 99%

External Counterpulsation Augments Blood Pressure and Cerebral Flow Velocities in Ischemic Stroke Patients With Cerebral Intracranial Large Artery Occlusive Disease

Lin

Xiong

Han

et al. 2012

Stroke

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Background and Purpose— External counterpulsation (ECP) is a novel noninvasive method used to improve the perfusion of vital organs, which may benefit ischemic stroke patients. We hypothesized that ECP may augment cerebral blood flow of ischemic stroke patients via induced hypertension. Methods— We recruited ischemic stroke patients with cerebral intracranial large artery occlusive disease and healthy elderly controls into this study. Bilateral middle cerebral arteries of subjects were monitored using transcranial Doppler. Flow velocity changes before, during, and after ECP were, respectively, recorded for 3 minutes while continuous beat-to-beat blood pressure data were recorded. Cerebral augmentation index was the increase in percentage of middle cerebral artery mean flow velocity during ECP compared with baseline. Transcranial Doppler data were analyzed based on ipsilateral or contralateral to the infarct side. Results— ECP significantly increased mean blood pressure of stroke patients and controls. During ECP, middle cerebral artery mean flow velocities of stroke patients increased on both ipsilateral and contralateral sides when compared with baseline (ipsilateral cerebral augmentation index, 9.64%; contralateral cerebral augmentation index, 9%; both P <0.001), but there was no increase in difference between the 2 sides when compared with each other. Mean flow velocities of controls did not change under ECP. After ECP, blood pressure and flow velocity of stroke patients returned to baseline level. Conclusion— ECP provides a new method of cerebral blood flow augmentation in ischemic stroke by elevation of blood pressure. Flow augmentation induced by ECP suggests the improvement of cerebral perfusion and collateral supply from infarct ipsilateral and contralateral sides.

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“…5 In regard to the collective prognostic impact of collaterals, the cumulative 10-year survival rates of patients with chronic stable CAD are significantly higher in patients with versus those without sufficient collaterals or high collateral relative to normal flow (collateral flow index [CFI]; Figure 5). 11 On the basis of these prognostic benefits and the given therapeutic options of collateral growth promotion (termed arteriogenesis) 12,13 and in the context of frequently unfeasible conventional revascularization options, an individual quantitative assessment of collateral function is important. The purpose of this article is to review the theoretical background and the different methods for assessment of collateral function, with a specific focus on quantitative methods (for a summary, see the Table).…”

mentioning

confidence: 99%